Singapore’s “War on Diabetes”: What else can be done?
This 14 November marks World Diabetes Day, a global event that is aimed at raising awareness about diabetes and its impact on millions of people worldwide.
Diabetes, particularly type 2 diabetes, is a growing global health crisis driven largely by lifestyle factors.
Singapore’s battle against this chronic disease began in 2016 when the government declared a "war on diabetes." But how much progress has been made, and is there more to be done?
Encouraging, but Modest Gains
Singapore has seen some improvement since 2016, though cautiously optimistic, experts agree more is needed. The National Population Health Survey (NPHS) reports that in 2022, 1 in 12 Singaporeans had diabetes, a slight decline from 8.8% in 2017 to 8.5% in 2022. While these numbers suggest progress, diabetes remains complex, with genetics, lifestyle, and diet each contributing factors.
In a Channel News Asia article, Dr Sue-Anne Toh, co-founder of Novi Health and adjunct Associate Professor of Medicine at Yong Loo Lin School of Medicine at the National University of Singapore (NUS) said:
"We didn't go up in terms of prevalence, and we even went down slightly. While this is a promising sign, it is still too early to come to a definitive conclusion.”
"It's definitely in the right direction. Given that globally (the prevalence rates) are going up, we have been able to keep ours the same or even slightly lower, which is good."
Understanding Diabetes’ Scope and Impact
Diabetes primarily includes type 1 and type 2 diabetes.
Type 1 diabetes arises when the body loses its ability to produce insulin. Though it can develop at any age, it is more frequently diagnosed in children and young adults. Factors like genetics and certain viral infections are thought to play a role in its onset.
Type 2 diabetes, the most prevalent form worldwide, occurs when the body either doesn’t produce enough insulin or the insulin isn’t used effectively. This form of diabetes accounts for more than 90% of all cases.
While type 1 diabetes is usually genetic and occurs when the body stops producing insulin, type 2 diabetes, the more common form, links closely to lifestyle factors like obesity and inactivity.
You are more likely to develop type 2 diabetes if you have any of these risk factors:
You are aged 40 and above.
Your parent or sibling has type 2 diabetes.
You are overweight.
You are inactive.
You have high blood pressure (greater than 140/90mmHg).
You have high levels of triglycerides.
You have low levels of high-density lipoprotein (HDL) (also known as “good cholesterol”).
You have had gestational diabetes previously.
You smoke.
You have prediabetes.
Diabetes as a Growing Worldwide Crisis
Singapore’s challenges with this chronic disease isn’t unique. According to the International Diabetes Federation (IDF), 537 million adults globally lived with diabetes in 2021, nearly double the count in 2011, with numbers predicted to exceed 1.31 billion by 2050. Type 2 diabetes makes up more than 96% of these cases.
Singapore’s Initiatives in the War on Diabetes
This symbol means that no additional free sugars or ingredients containing free sugars were added during the processing of the product. | Source: https://www.healthhub.sg/live-healthy/make_healthier_choice
Since 2016, Singapore has introduced several initiatives targeting diabetes’ risk factors, such as obesity. The Health Promotion Board (HPB) extended its Healthier Choice Symbol (HCS) program, which labels food products with lower levels of salt, sugar, or fat. This has spurred healthier consumer choices: the market share of HCS-labeled products grew from 18% in 2016 to 25.4% in 2018. Additionally, the Nutri-Grade labeling system, implemented in 2022, assigns grades from A (healthiest) to D (least healthy) to beverages, pushing vendors to offer less sugary options. Since the introduction of Nutri-Grade labels, the median sugar content in packaged drinks fell from 7.1% in 2017 to 4.6% in 2023.
Beyond diet, Singapore has promoted physical activity through HPB’s National Steps Challenge, which rewards participants based on their activity levels. Launched in 2015, the program has seen significant success, with 1.7 million participants. Since 2023, eligible users of the Healthy 365 app have been automatically enrolled, with new features and milestone-based challenges added to further motivate activity.
What else can be done?
While Singapore has made substantial strides, more can be done to reduce the impact of type 2 diabetes.
Maintaining awareness, regular health screening, and sustaining lifestyle changes are important in our fight against diabetes.
Health Screening
The Ministry of Health (MOH) estimates that about one third of diabetics don’t even know they have it. As the saying goes, “Knowing is half the battle won”.
To be tested for diabetes in Singapore, you will need to get your blood sugar (glucose) tested by having a small sample of your blood drawn from your arm, and sent to a lab for testing or you may opt for screening through a point of care testing done via finger prick.
There are four different types of tests for type 1 and type 2 diabetes in Singapore - Fasting blood sugar, casual blood sugar, Glycated hemoglobin (HbA1c) and Oral Glucose Tolerance Test (OGTT). Most general practice (GP) clinics in Singapore should be able to draw a blood sample from your arm and send it to a lab, who can do any one of the four tests for diabetes. Call to check with the clinic if their regular health screening already includes a test for diabetes.
Recommended Reading: Diabetes Treatment in Singapore 2024: A Complete Guide (Costs and More)
Nutrition
Key dietary principles for managing blood glucose include controlling carbohydrate portions and choosing complex over refined carbs, which cause slower, steadier rises in blood glucose. Filling just a quarter of your plate with carbs, like whole grains, sweet potatoes, or lentils, can help regulate glucose levels. Pairing carbs with protein, fiber, or healthy fats, and consuming fiber, protein, or fats before carbs, also aids in glucose control. Eating unprocessed, fiber-rich foods like vegetables, fruits, nuts, and whole grains not only supports digestion and reduces inflammation but also enhances satiety and insulin sensitivity. Finally, limiting saturated fats and choosing whole foods ensures balanced nutrients without excess fat, sugar, or salt, promoting better overall glucose control.
Recommended Reading: How to have a better diet for diabetes - 7 Key dietary principles to follow
Exercise
Exercise can help manage blood sugar levels by promoting muscle growth, reducing fat, and enhancing overall health and well-being. A balanced routine should include aerobic (cardio), strength training, and flexibility exercises. Aim for at least 30 minutes of cardio, such as walking, swimming, or biking, on most days, and add 20–30 minutes of strength training two to three times a week for improved glucose control. If you don’t have a gym, use body weight, resistance bands, or household items for strength exercises. Finally, stretching before and after workouts helps reduce muscle soreness and may also aid in blood glucose management.
Recommended Reading: How Does Exercising Help Diabetes—And What Exercises Should You Do?